Contracting Out Government Health Services

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Helpdesk Query:

The OECD have produced a handbook on contracting out government services in post conflict and fragile situations but are there any organisations offering long term technical assistance to countries to help guide them through this process?


This helpdesk response concludes that there are a large number of consulting firms that could provide long term technical assistance to countries considering contracting out government health services. A list of organisations providing this form of technical assistance is provided in Section 3.

Additionally, the main mandate of the Partnership of Democratic Governance, OECD was to set up a helpdesk for post-conflict and fragile countries to implement innovative service delivery mechanisms, including contracting out.  However, this closed in June 2011 and the niche the PDG filled remains to be filled by the donor community. INCAF’s members have not ruled out the possibility that this role be taken on by them in the next biennium (2013-2014). The World Bank has been doing some interesting work with public-private partnerships, but this doesn’t have the same operational element as the PDG.

Despite this, most specialists concluded that setting up a new organisation may be:

  • duplicative of expertise and capacity that already exists and is already done by different donors and management agents
  • risky from a market perspective since the new organisation would have, in essence, only one “product” on offer.

An additional challenge is often to coordinate the donor response in post conflict-fragile situations and to provide senior competency. If donor agencies would support that coordination component, the contracting out modality would benefit.


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